Children pulpotomy and pulpectomy

Sometimes, when a child had a severe dental trauma or due to large tooth decay affecting both, enamel and dentine, the paediatric dentist has to recommend the family the need to perform a treatment to the temporary tooth pulp (nerve), which can be partial (pulpotomy) or complete (pulpectomy). These dental treatments are commonly called “killing the nerve”, although it isn’t a professional or correct expression.

What is pulpectomy?

A pulpectomy is necessary when a child’s primary tooth has led to necrosis (death) of the dental pulp (nerve) or when it is affected in a non-reversible way. Sometimes the patient can also form a micro-abscess with pus: this means the dental pulp of a tooth has degenerated.

Through this treatment, the paediatric dentist eliminates the diseased dental pulp tissue (commonly known as “the nerve”) from the coronary and root area of the tooth. In other words, the paediatric dentist cleans out any inflamed, infected or damaged tissue which permits to keep the tooth healthy in the mouth without dental pulp. The empty conducts are re-filled with a special material that seals the roots, which will disappear in a progressive way at the same time permanent teeth press to appear in the gum area (“erupt”, “push”).


What is a pulpotomy?

Children´s pulpotomy is a pulp tissue treatment performed on primary teeth with severe tooth decay and/or superficial infection or inflammation of the pulp tissue located in the coronary area of the tooth. The difference with pulpectomy is that the pulp tissue of the root area of the tooth is not affected by disease yet.

The procedure eliminates the affected coronary pulp tissue, and protects from disease the unaffected pulp tissue located in the radicular conducts (roots) with a sealing material at the entrance of the orifices of the root.

Pulpotomy versus pulpectomy

The main difference between the pulpotomy and pulpectomy procedures in primary teeth relies on the amount of pulp tissue removed: it is partial in pulpotomy as only “superficial” coronary pulp tissue is removed, while it is complete in pulpectomy where removal of pulp tissue is performed on both the coronary and root area of the primary tooth.

Depending on the previous status of the tooth, in most cases, after a pulpotomy or pulpectomy a crown may be necessary, and in other cases, a restoration with esthetic resins can be used.

After clinical and radiographic diagnosis, an evaluation of the tooth risk assessment is performed. The paediatric dentist specialized in these treatments (pulpotomy and pulpectomy) will advise the child´s family to perform one treatment or the other.